1. Mosby items and derived items © 2005 by Mosby, Inc. Chapter 37 Client Safety

2. Mosby items and derived items © 2005 by Mosby, Inc. Environmental Safety Basic needs –Oxygen –Nutrition –Optimum temperature and humidity

3. Mosby items and derived items © 2005 by Mosby, Inc. Environmental Safety (cont'd) Physical hazards –Accidents –Lighting –Obstacles –Bathroom hazards –Security: fires, lead, carbon monoxide, break-ins

4. Mosby items and derived items © 2005 by Mosby, Inc. Environmental Safety (cont'd) Transmission of pathogens –Exposures –Immunizations

5. Mosby items and derived items © 2005 by Mosby, Inc. Environmental Safety (cont'd) Pollution –Air pollution –Land pollution –Water pollution –Noise pollution

6. Mosby items and derived items © 2005 by Mosby, Inc. Environmental Safety (cont'd) Terrorism –Bioterrorism: recognition and response

7. Mosby items and derived items © 2005 by Mosby, Inc. Risks at Developmental Stages Infant, toddler, preschooler –Exploration of the environment –Accidents and injuries School-age child – Activities: sports, bicycles

8. Mosby items and derived items © 2005 by Mosby, Inc. Risks at Developmental Stages (cont'd) Adolescent –Greater independence –Risk-taking behaviors –Driving –Accidents

9. Mosby items and derived items © 2005 by Mosby, Inc. Risks at Developmental Stages (cont'd) Adult –Lifestyle habits –Stress

10. Mosby items and derived items © 2005 by Mosby, Inc. Risks at Developmental Stages (cont'd) Older adult –Physiological changes –Falls, accidents

11. Mosby items and derived items © 2005 by Mosby, Inc. Individual Risk Factors Lifestyle Impaired mobility Sensory or communication impairment Lack of safety awareness

12. Mosby items and derived items © 2005 by Mosby, Inc. Risks in the Health Care Environment Medical errors Falls (90% of reported incidents) Client-inherent accidents – Seizures Procedure-related accidents Equipment-related accidents

13. Mosby items and derived items © 2005 by Mosby, Inc. Assessment Nursing history Client’s home environment Health care environment Risk for falls Risk for medical errors Bioterrorist attacks Client expectations

14. Mosby items and derived items © 2005 by Mosby, Inc. Nursing Diagnoses Risk for injury Deficient knowledge Risk for poisoning Disturbed sensory perception Risk for trauma

15. Mosby items and derived items © 2005 by Mosby, Inc. Planning Goals and outcomes Examples –Client does not suffer a fall or injury –Client identifies risks associated with visual impairment Setting priorities Continuity of care

16. Mosby items and derived items © 2005 by Mosby, Inc. Implementation Developmental interventions for injury prevention –Infant, toddler, preschooler –Adolescent –Adult –Older adult

17. Mosby items and derived items © 2005 by Mosby, Inc. Implementation: Home Environment Temperature and humidity Lighting Safety features Security measures Nutrition: food preparation Asepsis: cleanliness

18. Mosby items and derived items © 2005 by Mosby, Inc. Implementation: Acute Care Fall prevention Restraints –Legal guidelines –Restraint-free environment Side rails Fire safety (RACE)

19. Mosby items and derived items © 2005 by Mosby, Inc. Implementation: Acute Care (cont'd) Seizure precautions Poison control Electrical safety Radiation safety Bioterrorism response: emergency management plan Infection control

20. Mosby items and derived items © 2005 by Mosby, Inc. Evaluation Prevention of injury Client expectations